Reflections of a Two-Year Post-Op

nicole bullock 2 year gastric bypass

February 7th was my two year “surgiversary” of my roux-en-y gastric bypass surgery. I’ve been trying to decide how to commemorate this anniversary on my blog for a few weeks, and nothing felt quite right. I’ve got lots of pictures on Facebook, Instagram, and my blog that show my weight loss progress, so I didn’t want to focus on my external/physical changes. I wanted to touch on some thoughts and feelings about how I’ve changed on the inside…and how I’m still the same.

Reflections of a Two-Year Post Op:

I would like to lose more weight, but I am happy with where I am at: When I embarked on my weight loss journey, I had the ultimate goal of losing 200 pounds. On my absolute lowest day, I had a total of 131 pounds lost. That means that I’m still 70 pounds overweight, and I’m not completely satisfied at my progress. But setting the scale aside, I like ME a lot better. I can look into the mirror and like who is smiling back at me. I can find clothes that I feel comfortable and attractive in. My weight doesn’t hold me back from things that I’d like to do (biking, skiing, swimming, 12+ hour days of walking during travel, etc). I’ve got my problem areas that are managed by shapewear, but I’m not horrified by my bulges and loose skin. I like ME, and even if I don’t lose any more weight, I feel like my surgery was a success.

I still have my taste buds: Just because I had surgery to restrict the amount of food I can ingest, that doesn’t mean that I care if it tastes lousy. I do care. I love food, and willingly admit that I focus a lot of time and money on good food. I tried to get into the mindset “Eat to live, don’t live to eat,” but it doesn’t work for me. I have an emotional attachment to food, and I don’t think that any amount of therapy will change that. I like to celebrate with food, I like to be social around food, and I make better food choices when I just accept those truths. I am not as restricted by the types of food I tolerate as I was right after surgery. I can handle a small dessert without dumping. I eat more carbs than an average RNY patient to avoid reactive hypoglycemia. I usually don’t feel sick after having something rich or fatty. I can’t rely on my “tool” to limit the foods I eat by making me feel sick, so I have to think about the foods I eat. However, now that I’m eating more calories per day, I MUST be active. I feel lousy on days that I haven’t exercised, and I know that eating too much will make it tough to keep my weight in check.

Weight loss doesn’t fix everything: Surgery and the subsequent weight loss have helped me get my blood pressure under control, reduced edema and helped circulation in my legs, and has allowed me to be much more active. But the major disappointment with my pre-surgery comorbidities is that I still have obstructive sleep apnea. I had a sleep study in November that revealed that I have significantly improved my apnea, but I’m still advised to use a CPAP machine (at pressure 5). I have struggled with depression and anxiety since my teen years, and weight loss hasn’t changed those mental health challenges. If anything, I think I have more problems with anxiety. I’ve had some nutritional deficiencies that require ongoing management. I had mono last year, which made me feel tired and lethargic all the time. I consider myself MUCH healthier than I was in 2012, but I’m still not normal or perfect.

Forgive regain, to a point: For the first 10 months after surgery, the numbers on the scale went down consistently. But since December 2012, I’ve been in a constant struggle with my scale. On my absolute lowest weight day, I was at 242. But I was working out like a maniac at that point, having RH crashes too often, and I felt weak. Once my RH was under control, I came down with mono. And peritonsillar abscesses. And I had to go on steroids. And I had surgery. And my doctor restricted my from rigorous exercise for 2 months. On my worst day with the regain from surgery and steroids, I weight 261, 19 pounds up from my highest. For the last 2 months, I’ve been hovering between 248 and 252. I could freak out about what I’ve regained, but I have other things to worry about. However, my RED ALERT weight is 260. If I hit it again, I will be fighting it like gangbusters.

taylor and nicole 2 years


Relationships change, friends come and go
: WLS is like a magnifying glass on relationships – it makes the good things better, and the bad things worse. Taylor and I went through some tough times in our relationship prior to surgery, and I wasn’t sure how our marriage would fare post-op. Luckily, he has been an incredible support, I know how much he loves me, and my increasing health has only made our marriage stronger. But not all people can say the same.  It’s been interesting to watch my friends go through relationship changes since WLS: divorces, infidelity, marriages, serial dating, moving across state lines to be with the ones who make you feel loved. Those in abusive relationships tend to finally have the courage to move on, whether it is a romantic relationship or just a friendship. I’ve lost friends, but have gained many more. And some of the friends I’ve made since surgery have already moved on. You have to do what is best for your sanity, and sometimes that means that you rely on different people than you did in the past. It’s hard to move on, and I’ve shed tears over people I no longer have in my life, but I am so grateful to the ones who continually support me.

I’m not ready for plastic surgery: With all of my blogging and social media connections to the weight loss surgery world, I’ve seen some amazing transformations over the last few years. For many of them, they hit their goal weight in less than a year, and have reconstructive plastic surgery soon after. I’ve been fortunate to have minimal skin sagging and need for major reconstruction, but that may change as I lose more weight. And I haven’t ruled out the possibility of having another child yet, so I will wait for any additional surgery until I have a baby or decide to keep my family as is.

I’m not sure where I’m going with my blog next: I’ve had some pretty awesome opportunities through blogging about my weight loss. I’ve spoken at conferences, I’ve been on TV, I’ve been featured on health websites, and have a loyal group of followers online. But I’m in a bit of a “blog life crisis” – I don’t always feel like blogging about my health, I get offers from brands to review products and want to take advantage of those opportunities, but then I get behind with writing for me. I will probably be writing here less and less. I’ve got a time-intensive job that demands my attention more than past positions, and getting back on a computer after work rarely happens. I’ll post when I have something important to say, and not pressure myself to post for the sake of posting.

Wordless Wednesday: Two Year Comparison

gastric bypass weight loss comparison

Wordless Wednesday: Only Two Short Years Ago

before gastric bypass surgery nicole bullock

Checking In and Catching Up

nicole summer selfieOver two months without a blog post? Guilty. I have so much to catch up on, I decided to dust off the blog and catch up on my summer so far.

As I mentioned in a post on my other blog, I tend to struggle in the summertime. I’ve had some significant depressive episodes in summers past, but depression hasn’t been as much of an issue this year. I have been feeling a lot of anxiety, and I often feel like the anxiety is worse when I spend a lot of time online. I do my internet thing while I’m work (since I work as a social media manager), and then I am largely offline through the evening.

I’ve also been struggling with an unusual amount of fatigue. I’m always tired, sleep isn’t restorative, and I have a hard time concentrating on anything for an extended period of time. I usually have creativity and ideas bursting out of my brain, and now I struggle to even write a paragraph without distractions. I met with my doctor, and we both expected the fatigue to be related to a vitamin B-12 deficiency. I got my results back, and I actually had an above normal reading. He ordered a bunch of thyroid tests and checked for mono…but those findings were normal. The next step is to meet with my sleep specialist about my sleep apnea – I’ve been using my CPAP machine, but I feel like it’s not helping me feel rested. He guessed that after losing 80-100 pounds, I’d likely not need to use the CPAP anymore. Now that I’m down almost 130…I’d like to know definitively if it’s needed anymore.

I’m working on getting back on track with weight accountability. I haven’t been as obsessed with numbers lately, which is part of why I think I haven’t been losing. My current weight is 244. I was in a plateau between December and April, then I had a spike up to 261 around the time I went to Vegas. I got into bad habits while figuring out my carb intake to manage reactive hypoglycemia, and now it’s hard to go through any meal without something carby. When I returned from Vegas, I decided to get back to a stricter eating plan, and was able to drop that 15 pounds of regain in about 6 weeks.

fitbloggin trout lake farm tour
At the end of June, I went to Portland (my hometown!) to attend FitBloggin’ 13, a blogging conference for health, fitness, and weight loss bloggers. The first day of the conference, I went with a group to the Nutrilite Trout Lake Farms to see the world’s largest organic herb farm. We also made a stop at Multnomah Falls, which is one of my favorite places in the Portland area. I got a dose of “nature” before being inside a hotel for the majority of the weekend. I got to spend time with a lot of my blogging friends, and presented my session on SEO.

What’s coming up next for me?

This week I’m going to Phoenix for the Obesity Action Coalition’s Your Weight Matters Conference. I’m participating in the Walk from Obesity on Sunday with Team Bariatric Bad Girls. In October, I’ll be speaking at Obesity Help’s National Conference about connecting over social media for support, outreach, and accountability for weight loss. If you see me at either event, be sure to say hi!

Top Ten Non-Scale Victories of 2012

2012 has been an incredible year for me.

I have accomplished so much, and achieved goals that have previously seemed impossible. Obviously, the weight loss has been the highlight of my year. I weigh over 120 pounds less than I did going into 2012. But beyond the total pounds, there have been a lot of other non-scale victories (also known as NSVs in the weight loss community).

Some of my favorite NSVs:

  1. Having the energy to walk 10+ hours a day with my family in London
  2. Fitting into jeans and dresses that haven’t fit since I was newly married to my husband
  3. Being able to go on airplane flights without a seatbelt extender…and having extra slack on the seatbelt when I pull it taut.
  4. Seeing my collarbones again. And my knee bones. And my wrist bones.
  5. Acquiring an amazing support network, both online and offline, by sharing my story
  6. Meeting Beth (aka Melting Mama) and many friends from Bariatric Bad Girls Club
  7. Having the confidence to go on TV and be featured as KSL’s Blog of the Week 
  8. Being able to cross my legs comfortably
  9. Tossing aside my giant beach towel and using a regular-sized towel for bathing
  10. Looking at myself in the mirror…and seeing the real Nicole that I know has been there all along…

Here’s to an amazing 2013!

I Am Thankful

20121122-212920.jpg2012 has been such an amazing year for me. I am accomplished so much, made so many new friends, traveled to great places, have excelled in my career, and feel like I’m in the best place I’ve been in my adult life.

After the intense difficulties of 2009, 2010, and 2011, it has been such a blessing to have a good year. In the past three years, I dealt with 18 months of unemployment. I had a major injury to my back and hip that caused me to have limited mobility for 6 months. I had long-term bouts on steroids for flare-ups of my COPD and countless bouts of pneumonia and bronchitis, which led to 70 pounds of weight gain that felt out of my control. My sleep apnea was severe, and I was constantly fatigued. My mental health struggled. I did not feel like myself. I was doing my best, but it didn’t feel like it was ever enough.

20121122-214628.jpgAlthough I’m only 10 months out from surgery, I began preparing myself for surgery in late 2010. I started compiling medical records, met with my doctors to discuss my clearance for major surgery, and I did research on the different types of weight loss surgery available to me. After Cigna denied my surgery in Spring 2011 (pending an additional 6 months of physician-supervised weight loss), I had lost a lot of hope. I felt like I was stuck in my lot.

But in late January, my appeal for surgery was approved. I have had more success with my weight loss going the surgical route than I did in 20 years of attempts in every way imaginable. It has not been easy, but it’s been worth it.

120 pounds in 10 months. I still can’t believe it.

20121122-213012.jpgOur family is spending the Thanksgiving holiday in California with Taylor’s family. A lot of my friends back home were doing turkey trots or going to the gym to prepare for the massive gorgefests at Thanksgiving dinner. I told Taylor I wanted to go out on a lengthy walk to burn some calories before dinner. He told me about a route that he really likes through San Dimas Canyon, and told me it was just over 3 miles. Last year, I would have told him that he was crazy to suggest it. This year, I embraced the challenge and had a great time being active with my husband. The weather was gorgeous, with clear sunny skies.

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I grew up in Oregon, and being active in the outdoors feels like second nature for me. While my body wasn’t able to handle it, I really missed it. I’m so happy to be able to do things outside and not feel like I’m going to pass out.  I’ve started biking again. This winter, I’m planning on giving both skiing and snowboarding a try. I’m even thinking of trying my hand at group sports again.

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I am thankful for so many things. I am thankful for the courage I felt to make a bold and risky decision for my health, and for the courage to share my journey on my blog. I am grateful for the support that I’ve received from friends and family, and all of the new people I’ve become acquainted with through this blog and my online support groups. I am grateful for the reduction in my health comorbidities. I am grateful for my family, and the ability my newly regained health has allowed me to be the mother and wife that I’ve always tried to be. My heart is so full.

 

Hibernation

Every day since surgery, I’ve dealt with challenges. Usually the challenges are related to my body and the things that I can eat. Lately, it’s been a much more difficult battle mentally.

My body has changed a lot over the last 4 months. I’ve been through major surgery, I’ve dropped a lot of weight, I’ve likely had some nutritional deficiencies, and  all these changes take a toll.

Before surgery, I was given “the Bible” from my surgeon’s office. It’s a comprehensive binder full of information with food lists, side effects, warning signs, and facts about the different post-op stages. I read portions of the book daily for the first few weeks, but hadn’t picked it up for a while.

There is a phenomena called “hibernation syndrome” that is really common with gastric bypass patients. Patients are going through so many changes, and the body is getting used to far less food intake, and it causes fatigue and depression. People don’t feel like going out of the home or interacting with other people as much. It usually hits patients within the first few weeks after surgery, and gets better after about the 6 week mark. I didn’t really notice it at that point in time, but the last 3 weeks I’ve felt a lot different. I feel exhausted all the time, have been sleeping more, exercising less, and don’t feel like doing much. I don’t know if it’s directly surgery-related, or just due to other stress in my life.

I am going through a transition phase currently. I ended one job, started a new job, and I’m preparing to move.  So far I really like my new job – I think it’s a great fit, and I like the work that I’ll be doing. But there is always some anxiety about starting a new job and being “the new person”. I’m also a bit stressed because one of the perks of the job is a well-stocked fridge of drinks and a cupboard of treats and snacks. There are some “good” things that I can have, but there’s a lot of stuff I have to avoid. It will take a lot of will-power to avoid the foods that I know I shouldn’t have, but tempt me just because they are THERE. I’ve stocked my desk with some “safe” items that should satisfy me when the office treats are calling my name.

As for moving, we’re getting ready to move from our apartment in the Salt Lake valley into my parents’ basement in Lehi. It will be closer to work, which will be nice, but further from the city and airport (where I usually am at some point each week). It will be an adjustment to living in such close proximity to my parents and brother. However, it will help us tremendously financially. We’ve on a bunch of payment plans for my medical bills, in addition to all of our other monthly expenses and student loans. We’ll be able to position ourselves much better financially, but it will be a difficult loss of independence.

In happy news, I hit the 70 pound loss mark. I’m at 302.5, which is the least I’ve weighed since I lived in Atlanta in 2009. At that point in time, it was the most I’d ever weighed. I went on a pretty intense weight loss plan that didn’t yield a lot of weight loss, but instead threw my metabolism off for months. Pretty soon I’ll be to my “Michigan weight,” then my “California weight” and then to the weight I was when I married Taylor. Today he told me that when I get below 200, he’s taking me to Hawaii. Sounds like a great deal to me!

Forgive me if my posts are less frequent then usual, it’s been really hard for me to even turn on the computer. Once I’m off work, the last thing I want to do lately is get back on the computer. It’s a tough trade-off since most of my biggest supporters are online.

Hopefully this fatigue “hibernation” slump will be temporary. I’m going to make an appointment to see my surgeon and get my lab work done. If I can feel better just by figuring out if I’m deficient in a nutrient or two, it might explain why I’ve been so darn tired lately.

 

To Be Perfectly Honest…

Today will be one of my not so pretty posts. Even though I’m posting a pretty good picture of me.

April has been a really tough month emotionally. My weight loss has slowed considerably. I traveled out of town three weekends out of the month, and never was fully prepared for all the meals that I should have planned and brought along food for. Being unprepared brings temptations. And this month I’ve fallen prey to several temptations.

What have I eaten, you ask? I’m not telling you this so you can criticize me, I’m telling you so I can be honest with myself. I succumbed to pieces of Easter candy. I’ve eaten some full-fat ice cream instead of frozen yogurt. I’ve sipped on soda a few times. I’ve snacked on Cheetos Puffs a few times (even though I know they’re useless crap with no nutritional value). My portions haven’t been monstrous, obviously since I can’t really consume more than 3 ounces at once, but I know I’m off the wagon.

Most gastric bypass patients deal with a condition called “dumping,” where condition where ingested foods bypass the stomach too rapidly and enter the small intestine mostly undigested. This causes nausea, vomiting, bloating, cramping, diarrhea, dizziness and fatigue. It usually happens after eating high fat or high sugar foods. But as far as I can tell, I’ve never dumped. My body hasn’t equipped me with the mechanism to make me violently ill if I eat rubbish. I must be crazy for wishing my body did. I seem  to only get sick eating “healthy stuff” like eggs and chicken.

So yeah….bad food choices. In actuality, I’d say that 98% of what I eat is right on track, and 2% is “bad.” I’ve come up with all sorts of excuses why I’m sabotaging my weight loss like this, especially so early in the game. And the biggest source of anger and frustration is all the damn food advice people give me. It messes with me every time.

I’ve always been a pleaser – I want to make people happy by doing what they others ask me to do. But in the case of food advice as a weight loss surgery patient, it’s infuriating. I’ve been tempted to go back to people whose advice has been a catalyst for something bad happening and say “See what you did to me!!” For instance, a certain person has bugged me over and over to try eating a certain food. I had already had a hard time tolerating it, but I knew they wouldn’t get off my back until I ate it and reported back. So I finally ate it, and I violently threw it up. I ran back into the bathroom multiple times to wretch, and I even started vomiting blood. It wasn’t pretty. And the whole time, I was mad at this person who had so persistently advised me to eat it. Honestly, I know I should have stuck to my guns and ignored the advice. I should have been stronger. But I’m feeling weak and vulnerable these days, and now that I’ve had well over 100 people give me advice, it’s really messed with my head.

Unless you are a doctor or nutritionist – PLEASE do not give me advice on food. The only exceptions to this rule are 1) If you have PERSONALLY been a weight loss surgery patient (not your friend, not your family member) AND/OR 2) if I PERSONALLY ask you for advice. However well meaning you are, it is NOT helpful. I have an extremely limited amount of things that I can eat, and can only eat very limited quantities. I need to expand my palate when MY DOCTOR recommends it, NOT YOU. When I get food advice, it confuses me. I makes me want to start to push the limits of what’s right for me to eat. It makes me want to binge on junk food. Often the advice makes me cry. Sometimes it just makes me not want to eat at all, and fasting is NOT good for me at the stage.

Secretly in my head, I want to tell people who give me food advice, “Is it important enough for you that I eat ____ that it could risk our friendship? Okay then….SHUT UP!”

I think it’s time to go into counseling again. I need to grow a thicker skin.

A Few Thoughts

nicole hair blowing in the a/cI’ve had a lot on my mind lately, but not enough on every subject for a full post. How about some bullet points instead of paragraphs?

  • I’ve started dealing with some hair loss. It’s not enough for it to be noticeable to others, but it’s making me paranoid. My dark hair has been part of my “identity” the past few years because I haven’t liked a lot of my features being so overweight. It’s the longest it’s ever been, and I hope I don’t lose it. Last week I dyed my hair a shade darker because it’s supposed to hide hair loss.
  • When I look at myself in the mirror, I like what I see more and more. For a long time I’d stare and myself and not really recognize myself. It feels good to look more like myself than I have in several years
  • I’m having a very hard time being compliant with taking my vitamins and supplements. The smell of a multivitamin alone makes my stomach turn. Today I skipped splitting my MVI in half, and it got stuck in my pouch. I was painfully uncomfortable for hours, and was scared I would need to see the doctor. I finally decided to drink enough water to vomit (yes, gross I know), and felt soooo much better once the vitamin would out. But ugh…regurgitated vitamins taste much worse coming up than they do going down!
  • I’m getting really nervous about making it through the Color Me Rad 5K I’m doing on Saturday. I’ve amped up my exercise, but I’m worried I’ll collapse and pass out. I get so tired so easily since surgery. I’m going to really have to pace myself.
  • My friend Sue wrote a post, “Be Your Own Kind of Average” a few months ago about her weight loss surgery experience. I read it every few weeks. It has a lot of truth in it about life after WLS – especially the part about people start being nicer. People who wouldn’t have given me the time of day are starting to hold conversations with me. More people make eye contact and smile. It feels good, but it sort of feels awkward too.
  • Right now, all I want is a Coke Zero. Must be strong.

Hmmm…I guess I had enough content I didn’t need to use bullet points. Oh well, my thoughts are pretty scattered tonight.

One Month Of Beauty And The Bypass

It’s crazy to think it’s been a month since I started my weight loss surgery blog. 5 weeks ago I publicly announced that I was having gastric bypass surgery. I’ve talked about what I’ve eaten, the surgery process, emotional struggles with my obesity, post-operative complications, and added pictures along the way. Already I’m feeling healthier and more confident.

It hasn’t always been easy to talk about what I’m going through, and I’ve tried to be as honest about the process as possible. It’s been incredible to see how many people have reached out to me – those who have had surgery, those who are thinking about surgery, and those who purely appreciate sharing my journey. I’ve had some haters, I’ve had some rude and insensitive comments, but overall…I’m SO glad I decided to document the process.

Since I started the blog, my BMI has gone from 53.5 to 49.2, meaning I’ve gone from “super obese” back down to “morbidly obese”. Next step, I’ll just be “obese”. I’m down a little over 30 pounds, and I’m shrinking all over my body. These are my current measurements, with a total of how much I’ve lost:

  • Neck 16 (-.75)
  • Bust 50.5 (-1.5)
  • Chest 44 (-2)
  • Waist 45.5 (-4.5)
  • Upper belly 49 (-4)
  • Hips/butt 59.5 (-2.5)
  • Thigh 31 (-3)
  • Calf 23 (-1.5)
  • Ankle 11.5 (-1)
  • Bicep 18.25 (-1.75)
  • Forearm 13 (-1.5)
  • Wrist 7.5 (-1.5)

Being back to work has been a challenge. I’ve struggled with some major fatigue, some days it’s hard to stay even 3 hours, and I always follow-up my work shift with a hefty nap. I’m not sure how I’ll feel through the next few weeks, but I’m trying to be patient with my recovery. I’m still dealing with a lot of nausea and vomiting, but I’m getting more comfortable with what I’m able to eat (and how much). I’m still craving things that I can’t have (like Easter candy), but there’s reassurance that avoiding those “bad” foods will help me avoid getting sick.

Today’s food diary:

  • Light yogurt
  • 1 TB peanut butter
  • 2 oz marinara sauce, mushrooms, and cheese
  • 2 oz shredded pork, enchilada sauce, and cheese
  • 3 oz Simply Apple juice
  • String cheese